Common brand names:

Summary of Interactions with Vitamins, Herbs, & Foods

Replenish Depleted Nutrients

In a study of 34 people with hypertension, six months of captopril or enalapril (ACE inhibitors related to benazepril) treatment led to decreased zinc levels in certain white blood cells,1 raising concerns about possible ACE inhibitor-induced zinc depletion.

While zinc depletion has not been reported with benazepril, until more is known, it makes sense for people taking benazepril long term to consider, as a precaution, taking a zinc supplement or a multimineral tablet containing zinc. (Such multiminerals usually contain no more than 99 mg of potassium, probably not enough to trigger the above-mentioned interaction.) Supplements containing zinc should also contain copper, to protect against a zinc-induced copper deficiency.

Reduce Side Effects

In a double-blind study of patients who had developed a cough attributed to an ACE inhibitor, supplementation with iron (in the form of 256 mg of ferrous sulfate per day) for four weeks reduced the severity of the cough by a statistically significant 45%, compared with a nonsignificant 8% improvement in the placebo group.4

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.8, 9, 10 This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,11 potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),12, 13, 14 or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems.15 Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.32, 33, 34 This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,35 potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),36, 37, 38 or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems.39 Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.

Explanation Required

Amlodipine has been shown to raise blood levels of DHEA-sulfate in insulin-resistant, obese men with high blood pressure.40

Grapefruit

Ingestion of grapefruit juice has been shown to increase the absorption of felodipine (a drug similar in structure and action to that of amlodipine) and to increase the adverse effects of the medication in patients with hypertension. Until more is known, it seems that grapefruit juice should not be ingested by people taking amlodipine or similar drugs.43 The same effects might be seen from eating grapefruit as from drinking its juice.

Pomegranate juice has been shown to inhibit the same enzyme that is inhibited by grapefruit juice.47, 48 The degree of inhibition is about the same for each of these juices. Therefore, it would be reasonable to expect that pomegranate juice might interact with lotrel in the same way that grapefruit juice does.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers' package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The Aisle7 knowledgebase does not contain every possible interaction.

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2016.

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